Feature/Benefits

Plan “A”

Plan “B”

Cost

$19.50 per month (payroll deduction - level premium)

$16.00 per month (payroll deduction - level premium)

% of Wages Protected

100% of wages for Catastrophic Disabilities for 30 months
70% of wages Industrial causes
80% of wages Non-Industrial causes
(No reductions for Workers’ Compensation permanent disability settlements)

100% of wages for Catastrophic Disabilities for 30 months
70% of wages Industrial causes
75% of wages Non-Industrial causes
(No reductions for Workers’ Compensation permanent disability settlements)

Maximum Benefit

$9,000 per month, tax-free

$6,500 per month, tax-free

Waiting Period

30 calendar days – Earlier reduced benefits may be payable based on lack of personal leave down to zero days.  $750 per month Minimum benefit after 60 days, freeze of personal leave after 60 days ($500 per month if Industrial caused). No benefits are payable if working full time light or modified duty.

30 calendar days – Earlier reduced benefits may be payable based on lack of personal leave down to zero days.  $700 per month Minimum benefit after 60 days, freeze of personal leave after 60 days ($500 per month if Industrial caused). No benefits are payable if working full time light or modified duty.

Benefit Period

Lifetime coverage for Sickness, Accident and Pregnancy

Lifetime coverage for Sickness, Accident and Pregnancy

Sick Leave Integration Benefit

After 60 days,  you  may use 50% sick leave and receive a 50% benefit from Plan or use 100% sick leave and receive $750 per month ($500 per month if Industrial caused)

After 60 days,  you  may use 50% sick leave and receive a 50% benefit from Plan or use 100% sick leave and receive $700 per month ($500 per month if Industrial caused)

Musculoskeletal & Connective Tissue Disorders

Fully covered, no restrictions lifetime-non-industrial causes
(Age 65-industrial causes)

Fully covered, no restrictions lifetime-non-industrial causes
(Age 65-industrial causes)

Cost of Living Benefit (COLA)

4% compounded per year (beginning month 13 for 5 years) thereafter, CPI increase to age 65 and then continued lifetime.

4% compounded per year (beginning month 13 for 5 years) thereafter, CPI increase to age 65 and then continued lifetime.

Waiver of Premium

Once benefits are payable premiums are waived.

Once benefits are payable premiums are waived.

Benefits Payable During Disputed Worker’s Comp. Cases

After 60 calendar days - 70% of wages or maximum benefit of $9,000 per month (repayable if determined to be industrial)

After 60 calendar days - 70% of wages or maximum benefit of $6,500 per month (repayable if determined to be industrial)

Minimum Monthly Benefit

$750 per month - paid in addition to personal leave after 60 calendar days ($500 per month if Industrial caused)             

$700 per month - paid in addition to personal leave after 60 calendar days ($500 per month if Industrial caused)

Survivorship Benefits

Nine (9) months additional benefits to dependent beneficiary, plus $15,000 death benefit (Payable and delivered usually within 24 hours of notification)***

Nine (9) months additional benefits to dependent beneficiary, plus $10,000 death benefit (Payable and delivered usually within 24 hours of notification)***

Death Benefit

$15,000 death benefit on or off duty-Natural, accidental or terminally ill  (Payable and delivered usually within 24 hours of notification)***

$10,000 death benefit on or off duty-Natural, accidental or terminally ill  (Payable and delivered usually within 24 hours of notification)***

Pre-Existing Medical Condition Coverage

If you enroll during your initial enrollment period, all pre-existing medical conditions will be covered once you have been in the plan for twenty-four (24) / forty-eight (48)***months, unless you are eligible for the Prior Coverage Credit – otherwise, pre-existing medical conditions will not be covered.
SEE SPECIAL NOTE BELOW

If you enroll during your initial enrollment period, all pre-existing medical conditions will be covered once you have been in the plan for twenty-four (24) / forty-eight (48)***months, unless you are eligible for the Prior Coverage Credit – otherwise, pre-existing medical conditions will not be covered.

Ownership of Plan

Owned, operated and managed by members through a Board of Directors (non-profit and non-political California Corporation)

Owned, operated and managed by members through a Board of Directors (non-profit and non-political California Corporation)

SPECIAL NOTE: After December 31, 2007, if a union / association has not converted to Plan A, all medical conditions will be covered under Plan B.  If the union / association later converts to Plan A (after June 30, 2007), Plan A will only apply for medical conditions that arise or first manifest themselves after the conversion date.

**Benefits from Other Sources are applied to reduce amount payable from the Plan

***Forty-eight months for HIV, AIDS, ARC and for eligibility of Death Benefits on pre-existing conditions.

ILLUSTRATION ONLY ----- Certain conditions may apply.
 See Plan Documents for details. CA Insurance Lic. #0544968    jaf 1-07